Provider Demographics
NPI:1891008546
Name:GLADDING, MARGO SUZANNE (CNS)
Entity Type:Individual
Prefix:MRS
First Name:MARGO
Middle Name:SUZANNE
Last Name:GLADDING
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HOLMEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4630
Mailing Address - Country:US
Mailing Address - Phone:410-788-6990
Mailing Address - Fax:
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2992133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist